NPIMap

Individual provider Active NPI

Eddie Lares, MD

  • Emergency Medicine Physician
  • Loma Linda, CA
National Provider Identifier
1528264371
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A107364 Issued in CA
Practice address
11234 Anderson St
Llumc, House Staff Office CP 21005
Loma Linda, CA 92354-2804
Phone
(909) 558-8131
NPI assigned
Jun 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A107364 CA Primary

Addresses

Primary practice location

11234 Anderson St
Llumc, House Staff Office CP 21005
Loma Linda, CA 92354-2804

Mailing address

11234 Anderson St
Llumc, House Staff Office CP 21005
Loma Linda, CA 92354-2804
Phone (909) 558-8131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100723000764 CA Practitioner - Emergency Medicine 3173655370 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Stanford University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
JML Medical Group IncGroup PAC ID 4981075678, 2 clinicians
California Nursing ConsultantsGroup PAC ID 3577971449, 2 clinicians

Practice addresses (Care Compare)

4200 Peck Rd
Suite B
El Monte, CA 91732-2177
Phone (626) 350-5073

812 Poppyseed LN
Corona, CA 92881-3527
Phone (951) 496-4508

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
49 of 100Reported as individual
Quality
90
Improvement activities
0
Cost
10

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
JML Medical Group Inc Emergency Medicine CurrentSince Sep 16, 2022 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jul 1, 2010 Accepting new patients
California Nursing Consultants CurrentSince Feb 1, 2021 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jul 1, 2010 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Evergreen Spine and Pain Centers PastSince Jan 5, 2021 Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients

Locations

751 Medical Center Ct
#1182
Chula Vista, CA 91911

4200 Peck Rd
Ste B
El Monte, CA 91732
Phone (626) 350-5073

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1528264371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "LLUMC, HOUSE STAFF OFFICE CP 21005",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "LLUMC, HOUSE STAFF OFFICE CP 21005",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARES",
        "first_name": "EDDIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A107364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.